August 4, 2008

Health and life insurance companies have access to a powerful new tool for evaluating whether to cover individual consumers: a health “credit report” drawn from databases containing prescription drug records on more than 200 million Americans.

Collecting and analyzing personal health information in commercial databases is a fledgling industry, but one poised to take off as the nation enters the age of electronic medical records. While lawmakers debate how best to oversee the shift to computerized records, some insurers have already begun testing systems that tap into not only prescription drug information, but also data about patients held by clinical and pathological laboratories.

Traditionally, insurance companies have judged an applicant’s risk by gathering medical records from physicians’ offices. But the new tools offer the advantage of being “electronic, fast and cheap,” said Mark Franzen, managing director of Milliman IntelliScript, which provides consumers’ personal drug profiles to insurers.

The trend holds promise for improved health care and cost savings, but privacy and consumer advocates fear it is taking place largely outside the scrutiny of federal health regulators and lawmakers.

WANT to vet a baby sitter? Need to peek into the background of a prospective employee? Curious about the past of a potential date?

Last month, PeopleFinders, a 20-year-old company based in Sacramento, introduced CriminalSearches.com, a free service to satisfy those common impulses. The site, which is supported by ads, lets people search by name through criminal archives of all 50 states and 3,500 counties in the United States. In the process, it just might upset a sensitive social balance once preserved by the difficulty of obtaining public documents like criminal records.

Academics have a term for the old inaccessibility of records like those for criminal convictions: “practical obscurity.” Once upon a time, people in search of this data had to hire private investigators to navigate byzantine courthouses and rudimentary filing or computer systems, and to deal with often grim-faced legal clerks. In a way, the obstacles to getting criminal information maintained a valuable, ignorance-fueled civil peace. Convicts could start fresh after serving their time without strangers knowing their pasts, and there was little risk that unsophisticated researchers could confuse people with identical names.

Well, not anymore. The information on CriminalSearches.com is available to all comers. “Do you really know who people are?” the site blares in large script at the top of the page.

[...] Mr. Lane concedes that his site contains some mistakes. Every locale has its own computer system, he notes, and some are digitizing and updating records faster than others.

A quick check of the database confirms that it is indeed imperfect. Some records are incomplete, and there is often no way to distinguish between people with the same names if you don’t know their birthdays (and even that date is often missing).

IN the past, said Stacie R. Hankins, a special assistant at the United States Embassy in Rome, when the ambassador prepared to meet an Italian political figure, the staff would e-mail a memo about the meeting and attach biographies of those who would be attending to be printed out.

Today, she said, they still produce the memo, but “now they attach a link to the Diplopedia article” — Diplopedia being a wiki, open to the contributions of all who work in the State Department. The ambassador, Ronald P. Spogli, frequently reads the biographies on his BlackBerry on the way to the meeting.

The advantages are obvious, in efficiency and in saving paper, but it has required a leap of faith, too. For, theoretically at least, anyone at the State Department could have edited the biographies Mr. Spogli was reading — unlike traditional resources.

[...] The decision to embrace wikis is part of a changing ethic at the department, from a “need to know culture” to a “need to share culture,” said Daniel Sheerin, deputy director of eDiplomacy, which was created in 2003. “This is a technological manifestation of a policy difference,” he said, a change he dated to when Colin L. Powell was secretary of state.

People who were addicted to playing Scrabulous on Facebook have migrated by the thousands to Wordscraper, a Scrabble-like game created by the two brothers who built Scrabulous, Rajat and Jayant Agarwalla. Last week the brothers removed Scrabulous from Facebook.com for North American users because of a lawsuit from Hasbro, which owns the North American rights to Scrabble.

Unfortunately for Hasbro, players are not universally flocking to Hasbro’s official Scrabble game. Instead thousands are downloading Wordscraper, which has been available on Facebook since January but attracted little attention until Scrabulous shut down, and heading to their old favorite, Scrabulous, on the game’s independent Web site at www.scrabulous.com. Wordscraper had about 80,000 daily users on Facebook as of Sunday night and the Web site Scrabulous.com had thousands of players online on Sunday.

Hasbro’s official version of Scrabble on Facebook, meanwhile, has registered about 91,000 registered users, while a version from Mattel, which owns the rights to Scrabble outside of North America, has less than 15,000.

Unlike Scrabulous, which exactly mimics a Scrabble board, Wordscraper lets players pick a board size and put high-scoring spaces wherever they like — meaning that they can, if they choose, create an exact replica of a Scrabble board.

Consumers have long been frustrated with how much control carriers — AT&T, Verizon Wireless, Sprint and the like — have exerted over what they could download to their mobile phones. But in the last nine months, carriers, software developers and cellphone makers have embraced a new attitude of openness toward consumers.

[...] But the pressure on AT&T is also coming from another direction: Apple, its iPhone partner. AT&T has no control over the applications downloaded to the iPhones, which AT&T offers exclusively. But the proliferation of new applications and the realization that they only make cellphones more popular has convinced executives there that they need to give consumers more freedom.

The industry, of course, has selfish reasons for promoting openness. Applications spur the use of higher-priced wireless data plans and the purchase of more expensive smartphones. “What is most important for us is to have a customer sign up for a plan,” said Ralph de la Vega, who is in charge of AT&T’s wireless unit. “We think we can have multiple ways to make money.”